title: Risk factors for Barrett's esophagus in Indian patients with gastroesophageal reflux disease.
abstract: OBJECTIVE
  Barrett's esophagus (BE) is reported to be infrequent in Asians, with no data from India regarding its prevalence and risk factors. We investigated the frequency and risk factors of columnar mucosa with or without specialized intestinal metaplasia (SIM) in Indian patients with gastroesophageal reflux disease (GERD).
  
  
  METHODS
  A total of 278 GERD patients over 2 years underwent gastroscopy and completed a questionnaire for possible BE risk factors. Patients with columnar mucosa on endoscopy underwent four-quadrant biopsy; BE was histologically defined as columnar mucosa with or without SIM. Patients without columnar mucosa at endoscopy were considered as controls and compared to patients with BE and those with SIM.
  
  
  RESULTS
  Forty-six patients with GERD had columnar mucosa on histology (16.54%); 25 (8.99%) of these had SIM. The risk factors for BE were the presence of hiatus hernia (odds ratio [OR]: 3.14; 95% confidence interval [CI]: 1.2-8.17) and a history of eructation (OR: 2.28; CI: 1.11-4.66). The risk factors for SIM were age ≥ 45 years (OR: 2.63; CI: 1.03-6.71), hiatus hernia (OR: 3.95; CI: 1.24-12.56), and a history of eructation (OR: 3.41; CI: 1.19-9.78). Sex, severity of symptoms, dietary factors, tobacco or alcohol use, and body mass index were not associated with BE. The median circumferential segment length was 2 (1-10) cm, and the maximal length was 3 (2-11) cm in both groups.
  
  
  CONCLUSIONS
  BE is not an uncommon finding among Indian GERD patients. Age ≥ 45 years, history of eructation, and the presence of hiatus hernia are associated with SIM.
authors.affiliation: Department of Gastroenterology, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Mathew
authors.forename: Amita S
authors.initials: AS
authors.lastname: Joshi
authors.forename: Akash
authors.initials: A
authors.lastname: Shukla
authors.forename: Shobna J
authors.initials: SJ
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D001471:Barrett Esophagus / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors